Every day, 10,000 Americans celebrate their 65th birthday. While the U.S. is experiencing a longevity revolution, at the same time our aging nation is triggering a Silver Tsunami of chronic age-related disease that bring with it increased national health care spending, high rates of morbidity and mortality, and declines in quality of life.

In 2015, more than 1.6 million new cases of cancer are expected to be diagnosed and close to 600,000 people will die from the disease. Thankfully, major breakthroughs are changing how we prevent, treat, and cure cancer. Treatments are becoming increasingly personalized and advances in immuno-oncology, a field that uses the body’s own immune system to fight cancer, are causing a paradigm shift in cancer treatment. Use the navigation below and the search feature to view the data and to narrow down your search.

Approximately 85.6 million Americans suffer from some form of cardiovascular disease (CVD) and close to 1 in 3 deaths result from CVD. These are not only deadly but costly diseases with CVD and stroke costing around $320 billion each year.

Every year around 75,000 Americans learn that they have atrial fibrillation (AFib)—the most common type of arrhythmia, or abnormal heart rhythm. Having AFib puts people at an increased risk for stroke, which can be both deadly and costly. Medicare alone is estimated to pay .7 billion per year to treat newly diagnosed atrial fibrillation patients.

Stroke is the 5th leading cause of death in the U.S. and kills more than 129,000 people each year. Someone in the U.S. has a stroke about once every 40 seconds. People do survive stroke--around 795,000 strokes occur each year and there are an estimated 7 million stroke survivors in the U.S.--but they are often left with significant disabilities.

Each year around 75,000 Americans are diagnosed with atrial fibrillation (AFib), 900,000 experience a venous thromboembolism event (VTE), and 800,000 have a stroke. The burden for those who survive is enormous and the cost of care a major expense for individuals and the nation. Fortunately research advances are offering significant hope. A number of investigative anticoagulants have the potential to reduce strokes in AFib patients while also reducing the risk of bleeds; clot-dissolving agents are proving to lessen the effects of strokes; and the same drugs in the pipeline for AFib could prevent VTE after major orthopedic surgery.

As many as 11.6 million Americans in the U.S. have heart valve disease (HVD), and more than 1 in 10 adults ages 75 and older have HVD. Thankfully, the HVD field has experienced tremendous advances in improving survival, recovery, and quality of life for patients.

Aortic stenosis is one of the most common and serious types of heart valve disease. Aortic stenosis can be debilitating, costly, and deadly. Survival rates without treatment for severe symptomatic aortic stenosis are low at 50% at 2 years after symptom onset, and 20% at 5 years. Fortunately, innovative treatments are saving lives and aortic stenosis can be successfully treated with valve replacement in patients of all ages.

While medical innovations and public health gains in the past century have been measurable in leaps and bounds, significant progress against acute disease has revealed an equally enormous challenge—chronic disease on an unprecedented scale. Close to half of Americans have chronic conditions and 1 in 4 have more than one. They cause 7 out of every 10 deaths and cost our country 75 cents of every health care dollar. With chronic disease prevalence growing at a faster rate than the population as a whole, the forecast is daunting.

Despite recent advances, diabetes continues to be a major health threat for at least 29 million Americans who have it and the 86 million Americans with prediabetes. The biggest concerns for individuals with the disease are its many complications and co-morbidities; which can cause vision loss, heart disease, stroke, and other debilitating medical conditions. With the aging of the population and the rise in risk factors like obesity, these problems are going to skyrocket, making medical innovation more critical than ever.

Every year, between 50,000 and 90,000 adults in the U.S. die from vaccine-preventable infectious diseases or their complications. Many serious infectious diseases are acquired in the healthcare setting and those healthcare-associated infections cost U.S. hospitals between $28.4 and $45 billion each year.

Healthcare-associated infections (HAIs) are acquired while receiving medical or surgical care for other conditions in hospitals, physician offices, long-term care facilities, and other healthcare settings. They are largely preventable, yet often costly and deadly, and rapidly becoming a national crisis as they increasingly develop resistance to drugs.

Vaccine preventable illnesses and diseases continue to cause significant sickness, hospitalization, pain, disability, and death in the United States. Pneumonia causes somewhere between 300,000 and 600,000 hospitalizations in older adults each year, and more than 50% of flu-related hospitalizations are in people age 65 and older. Around 50% of the more than 1 million cases of shingles each year are in people age 60 and older.

Between 5 and 10 million Americans acquire pneumonia, 35 to 50 million are afflicted with influenza, and 1 million get herpes zoster (shingles)--each year. Older Americans are much more likely to get these infections and to suffer from complications and death. In fact, the death rate from pneumonia and influenza combined is close to 130 times higher in people age 85 and older, compared to people ages 45 to 54. Thankfully, vaccinations are available for many of the most common and deadly infectious disease in older Americans, and can save countless lives and healthcare dollars.

The prevalence of diseases like Alzheimer's and Parkinson's are skyrocketing as our population ages and they threaten to bankrupt our economy if better treatments and cures aren't found. 5.4 million Americans are currently diagnosed with Alzheimer’s disease. This number will triple to 16 million by the year 2050. Parkinson’s disease affects 1 million Americans, with at least 60,000 new cases occurring each year.

As many as 5.4 million Americans are living with Alzheimer's disease--the sixth-leading cause of death. This disease threatens to bankrupt our economy as our nation ages. In 2012, the cost of providing care for Alzheimer's disease patients was 0 billion. If current trends continue, this cost is projected to grow to .1 trillion per year by 2050, resulting in an overwhelming economic burden.

As many as 1 million Americans live with Parkinson's disease. It is estimated that about 50,000 new cases of Parkinson’s disease are diagnosed in the US every year. This disease is costly and devastating, costing around billion per year or ,626 per patient per year, often leading to disability and death.

More than 54 million Americans face the threat of osteoporosis; which causes more than 2 million fractures each year. These fractures can have a profound impact on quality of life—often leading to pain, disability, loss of independence, and even death—and cost the U.S. an estimated billion each year. Fortunately, scientists are continuing to make exciting breakthroughs that are helping to keep bones healthy and prevent debilitating fractures. The Alliance for Aging Research partnered with the National Osteoporosis Foundation to produce this volume.

Around 100 million Americans live with persistent pain--more Americans than are affected by diabetes, heart disease, and cancer combined. Persistent pain is a significant public health problem, costing the American economy around $560 to $635 billion annually. This amount is equal to a cost of $2,000 for every US citizen due to cost of health care and lost productivity.

More than 38 million Americans age 40 and older are blind, visually impaired, or have an age-related eye disease, and adult vision loss costs our economy more than billion a year. With major advances in vision research bringing new prevention and treatments, it is critical that support for research and incentives for innovation remain a priority. The Alliance for Aging Research has teamed up with the Alliance for Eye and Vision Research (AEVR) during their Decade of Vision, to release Volume II of The Silver Book®:Vision Loss. Volume II brings updated data on vision loss in older Americans, as well as the exciting changes and discoveries in vision research and treatment.

Diabetes is becoming increasingly common in industrialized and even developing countries. A serious and irreversible complication of diabetes--diabetic retinopathy (DR)--could impact as many as 191 million people around the globe by 2030. Despite the fact that DR is a leading cause of vision loss around the world, as many as 50% of people with diabetes are not getting regular eye exams, or are diagnosed too late for treatment to be effective. The diabetic retinopathy fact sheet was released on May 19th during a webcast. Click here to read the transcript, see the slides, and listen to the webcast audio.

Welcome

The Silver Book® is an almanac of thousands of facts, statistics, graphs, and data from hundreds of agencies, organizations, and experts. It is a searchable database, produced and updated by the Alliance for Aging Research, that provides free and easy access to the latest information on the burden of chronic diseases that disproportionately impact older Americans, and the value of investing in medical research.

Infection

Every year, between 50,000 and 90,000 adults in the U.S. die from vaccine-preventable infectious diseases or their complications. Many serious infectious diseases are acquired in the healthcare setting and those healthcare-associated infections cost U.S. hospitals between $28.4 and $45 billion each year.

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Among 187,697 hospital admissions for medical reasons that were associated with an unplanned 30-day readmission, 147,084 had a diagnosis of sepsis, 15,001 had a diagnosis of AMI, 79,480 were diagnosed with heart failure, 54,396…[ Get More Details ]

Cost of infectious disease in unvaccinated individuals

Unvaccinated individuals are responsible fror almost 80% ($7.1 billion) of the $9 billion economic burden of vaccine-preventable diseases in 2015. Note that the cost is based on the vaccine-preventable illnesses…[ Get More Details ]

Cost of vaccine-preventable diseases

Vaccine-preventable diseases relevant to the ten vaccines recommended for US adults, cost an estimated $9 billion in 2015.
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Sepsis in hospitalized patients

Hospitalized patients with sepsis who survived to 31 days experienced a 16.2% absolute increase in late mortality.
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Late Mortality and Sepsis

Compared with patients not in the hospital, sepsis in hospitalized patients was associated with a 22.1% increase in late mortality during a 2 year follow-up period.
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Dramatic increase of antibiotic resistance between 1981 and 2001

Source of 99,000 annual deaths from HAIs

Of the 99,000 annual deaths from HAIs:
35,967 are from pneumonia
30,665 are from bloodstream infections
13,088 are from urinary tract infections
8,205 are from surgical site infections; and
11,062 are from infections at other…[ Get More Details ]

~1.7 million Americans develop hospital-acquired HAIs annually

MRSA kills more than emphysema, HIV/AIDS, Parkinson’s, and homicide combined

In one year, MRSA killed more Americans (~19,000) than emphysema, HIV/AIDS, Parkinson’s disease, and homicide combined.
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MRSA infections increase in older patients

In 2008, 75% of healthcare-associated invasive MRSA infections occurred in patients older than 50, with 46% in patients older than 65%.
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Close to 1/2 of HAIs in patients 65+

Around 45% of all hospital-acquired HAIs in 2007 were in patients age 65 and older.
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~3/4 of all HAIs occur outside of ICU

Nearly 3/4 of all hospital-acquired HAIs occur outside of the intensive care unit (ICU).
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Primary sources of HAIs

Around 2/3 of all HAIs are central-line associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. Surgical site infections and Clostridium difficile (C. difficile) are also common HAIs.
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HAIs cost patients additional $43,000 per hospital stay

Patients with HAIs cost, on average, $43,000 more per hospital stay than those without an infection ($52,096 vs. $9,377).
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Drug-resistant MRSA expensive to treat

As an example, the median treatment cost for drug-resistant MRSA patients over a 6-month period was 118% higher than the cost of treating drug-susceptible MRSA strains.
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Around $35 billion cost to society from antibiotic resistant infections

The societal costs of antibiotic resistant infections are around $35 billion each year- this includes the cost of lost wages and premature deaths.
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Drug-resistant infections cost the U.S. healthcare system between $16.6 and $26 billion in extra costs each year.
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Drug-resistant infections increase length & cost of hospital stays

Drug-resistant infections increase the length of hospital stays by more than 23% and the cost by close to 30%.
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Infection and related sepsis leading cause of death in noncardiac-ICUs

Infection and related sepsis/septicemia are the leading cause of death in noncardiac-ICUs, accounting for as many as 60% of deaths.
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Sepsis accounts for 17% of in-hospital deaths

In 2008, only 2% of hospitalization were for sepsis/septicemia, yet they made up 17% of in-hospital deaths.
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Patients hospitalized for sepsis experience poor outcomes

Compared with patients hospitalized with other diagnoses, patients hospitalized for sepsis/septicemia are:
1/2 as likely to be discharged home
2 times more likely to be discharged to other short-term care
3 times more…[ Get More Details ]

Significant increase of penicillin-resistant Streptococcus penumoniae

Antibiotic resistance of Klebsiella pneumoniae on the rise

Resistance of Klebsiella pneumoniae to antibiotics has dramatically increased- from 5.3% to 11.6% for third generation cephalosporins (between 1999 and 2010), and from <0.1% to 4.5% for carbapenams (between 2002…[ Get More Details ]

Over 8 years infection control practices saved ~27,000 lives and $1.8 billion

Infection control practices saved an estimated 27,000 lives and $1.8 billion in medical costs between 2001 and 2009.
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An antibiotic stewardship program saved $17 million over 8 years

An antibiotic stewardship program saved a total of $17 million over 8 years, with antibiotic costs rising $1 million in the first year after discontinuation.
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Vaccines save lives and money

Between 2001 and 2010, vaccine use prevented an estimated 170,000 severe pneumococcal infections and 10,000 deaths, and saved an estimated $310 million in direct medical costs each year.
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Pre-surgery antibiotic use reduces 6-day mortality by 50% in elderly

Effective pre-surgery antibiotic use can reduce 60-day mortality in the elderly by 50%.
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Only a 20% reduction in drug-resistant infections would save $3.2 – $5.2 billion each year

A 20% reduction in drug-resistant infections would save between 5.7 and 11.3 million additional hospital days and between $3.2 and $5.2 billion in healthcare costs, each year.
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Reduction in hospital-acquired HAIs could produce significant savings

Practices that lead to a 20% reduction in preventable hospital-acquired HAIs would save up to $6.8 billion in medical costs. a 70% reduction would lead to a savings of up…[ Get More Details ]

Pneumonia Death Rate by Age in 2004

Global use of vaccine prevents death

Compared to estimated deaths without vaccination, global use of vaccination in 2001 prevented: 61% of measles deaths; 69% of tetanus deaths; 78% of pertussis (whooping cough) deaths; 94% of diphtheria…[ Get More Details ]

Flu causes close to 1/2 of lost workdays and low productivity in adults 50-64 during flu season

During influenza season, influenza-like-illness is responsible for 45% of workdays lost and for 49% of low productivity days among working adults aged 50–64 years.
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Significant savings from zoster vaccine

In a cost-effectiveness analysis, investigators estimated the zoster vaccine cost $44,000 per quality-adjusted life year saved for a 70-year-old woman.
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Use of shingles vaccine could save $82 to $103 million

Use of the shingles vaccine in immunocompetent adults ages 60 and older could save between $82 and $103 million in healthcare costs associated with the diagnosis and treatment of shingles,…[ Get More Details ]

Potential savings from shingles vaccine

Use of the shingles vaccine in immunocompetent adults ages 60 and older could save between $82 and $103 million in healthcare costs associated with the diagnosis and treatment of shingles,…[ Get More Details ]

Shingles vaccine could improve QALY and save money

Vaccination of 1 million people age 60 and over with the shingles vaccine would result in 11,919 non-discounted and 8,782 discounted QALYs (quality of life years) gained and save around…[ Get More Details ]

Potential cost effectiveness of shingles vaccines

The projected cost-effectiveness of a shingles vaccine for adults age 60 and older was estimated at $15,390 – $22,474 from the payer perspective, and $14,450 to $21,524 from the societal…[ Get More Details ]

Cost-effectiveness of flu vaccine

Vaccination for pandemic influenza (pH1N1) prior to an outbreak produces incremental cost-effectiveness ratios for individuals without high risk conditions, ranging from $8,000 to $52,000 per quality-adjusted life year.
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Economic value from flu vaccine in elderly

As over 60% of the economic burden of influenza falls on those ages 65 and older, programs to reduce the impact of influenza on older Americans would have the greatest…[ Get More Details ]

Each flu case prevented could save $60 to $4,000

The influenza vaccination could save between $60 and $4,000 per case prevented.
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Savings from flu vaccine

Vaccination for influenza resulted in an average annual cost savings of $13.66 per healthy working adult vaccinated.
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Cost of pneumonia vaccine

Addition of PCV13 (13-valent pneumococcal conjugate vaccine) to previously recommended pneumococcal polysaccharide vaccine for immunocompromised adults cost $70,937 per quality adjusted life year compared to no vaccine.
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Potential value of pneumonia vaccine

Use of PCV13 (13-valent pneumococcal conjugate vaccine) in older adults is estimated to have the potential to reduce total healthcare costs by $3.5 billion and total societal costs by $7.4…[ Get More Details ]

Value of smallpox eradication

An estimated $100 million spent in eradicating smallpox from 1967 to 1977 saved the world around $1.35 billion a year.
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Value of polio eradication

Eradication of polio is estimated to produce savings to governments of $1.5 billion per year.
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Cost of measles much higher than vaccine

One case of measles can cost 23 times as much as a single vaccination to prevent it.
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Cost effectiveness of MMR vaccine

For every dollar spent on the MMR (measles, mumps, and rubella) vaccine, $21 is saved.
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Vaccines cost ~$50 per healthy life year saved

Most vaccinations cost less than $50 per healthy life year saved. In contrast, treating hypertension costs between $4,340 and $87,940 per healthy life year saved.
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Cost savings from immunization

Every dollar spent on immunization saves $6.30 in direct medical costs – a total savings of $10.5 billion. When including indirect costs such as lost days of work, disability,…[ Get More Details ]

Shingles vaccine would reduce healthcare use

Use of the shingles vaccine in immunocompetent adults could eliminate more than 300,000 outpatient visits, 375,000 prescriptions, 9,700 emergency room visits, and 10,000 hospitalizations.
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Use of shingles vaccines significantly reduced disease burden

Use of a live attenuated VZV (varicella-zoster vaccine) in a randomized trial reduced the burden of illness from shingles by 61.1% and the incidence of postherpetic neuralgia (PHN) by 66.5%.
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Shingles vaccine reduces incidence by >50%

Use of a live attenuated VZV (varicella-zoster vaccine) in a randomized trial reduced the incidence of shingles by 51.3%.
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~One-third of shingles death preventable with vaccine

Approximately one-third of shingles deaths may be preventable through vaccination.
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Annual flu vaccine could save 275,000 QALYs

Offering the influenza vaccine annually to all people over the age of 50 would save around 275,000 quality-adjusted life years over the lifetimes of a birth cohort of 4 million.…[ Get More Details ]

Mortality rates in nursing home residents were 42% lower in facilities with higher staff vaccination coverage compared with control facilities.
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Staff flu vaccination reduces incidence of staff and patients

Vaccination of staff in a tertiary care facility over a period of 12 influenza seasons increased vaccination coverage from 4% to 67%, reduced laboratory-confirmed cases of influenza amongst staff from…[ Get More Details ]

Influenza vaccine use reduces antibiotic use

Use of LAIV (live attenuated influenza virus) in healthy adults ages 18 to 65 reduced antibiotic use by 43% to 47%.
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Flu vaccine use reduces disease burden

Use of the LAIV (live attenuated influenza virus) in healthy adults ages 18 to 64 reduced febrile illness by 19% and upper respiratory tract illnesses by 24%. It also…[ Get More Details ]

Flu vaccine use can reduce illness risk in U.S. by 60%

Recent studies from the Centers for Disease Control and Prevention show that the influenza vaccine can reduce the risk of illness in the overall U.S. population by around 60%. …[ Get More Details ]

Over 6 years, flu vaccine prevented >110,000 hospitalizations and 5.8 million medical visits

Over a 6-year period (2005 – 2011), the influenza vaccine prevented more than 110,000 hospitalizations and 5.8 million medical visits.
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Over 6 years, flu vaccine prevented ~13 million cases

Over a 6-year period (2005 – 2011), the influenza vaccine prevented an estimated 13 million influenza cases–between 1.1 million and 5 million annually.
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Use of pneumonia vaccine in children reduced rates in adults age 65+

Within a year of introduction of PCV7 (7-valent pneumococcal conjugate vaccine) for use in the U.S. in infants, children under 2 years, and high risk children ages 2 to 4;…[ Get More Details ]

Effectiveness of pneumonia vaccine

PPSV23 (pneumococcal polysaccharide vaccine) protects against 23 types of pneumococcal bacteria and is 60% to 80% effective in preventing pneumococcal bacteremia in adults over the age of 65 who are…[ Get More Details ]

Vaccines in development 2013

Eradication of smallpox has saved 40 million lives worldwide

Since global vaccination efforts wiped out smallpox disease in 1979, infections in 350 million people have been prevented and 40 million lives have been saved.
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Polio vaccination prevented 5 million cases of paralysis since 1988

Vaccination for polio reduced the number of worldwide cases from more than 300,000 per year in the 1980s to only 2,000 in 2002—also preventing an estimated 5 million cases of…[ Get More Details ]

Pertussis vaccination reduced global cases

Vaccination helped reduce global pertussis (whooping cough) cases from 3 million per year to less 250,000.
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Diptheria vaccine significantly reduced annual cases

Vaccination has played a significant role in reducing diphtheria cases from 80,000 in 1975 to less than 10,000 per year.
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Measles vaccines reduced cases from 6 million to 1 million per year

Vaccination for measles reduced the number of worldwide deaths from 6 million in 1974 to less than 1 million per year.
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Life years saved from infectious disease eradication

Infectious disease eradication in the U.S. led to the following annual life years saved (LYS):
5,811,852 for measles
42,702 for tetanus
212,690 for polio
1,685,740 for smallpox
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Shingles causes an average of 129 hours lost work per episode

Patients with shingles (including those progressing to postherpetic neuralgia) lose an average of over 129 hours of work per episode, including losses of 12 or more hours of work time
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The shingles vaccine-eligible population (i.e., persons aged 60 years or older) accounted for 74% of the total annual shingles-related hospital charges in 2004.
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Costs of shingles

Among patients with acute episodes of shingles, average expenditures ranged from $112 to $287 per episode of outpatient care, $73 to $180 per antiviral treatment, and $3,221 to $7,206 per…[ Get More Details ]

Flu costs US $16.3 billion in lost earnings each year

Lost productivity and loss of life due to influenza amounts to $16.3 billion of lost earnings annually.
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>1/2 of flu’s economic burden from people 65+

An estimated 64% of the total economic burden of influenza comes from those over 65 years old.
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Medical expenses for Medicare patients with pneumonia higher

Medicare patients hospitalized for pneumonia have medical expenses—during the hospitalization and for a year afterwards—that are $15,682 higher than in Medicare patients without pneumonia.
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Cost of hospital-treated pneumonia in Medicare patients

Cost of pneumonia and flu more than $40 billion in 2005

In 2005, pneumonia and influenza combined cost the U.S. $40.2 billion—$34.2 in direct costs and $6 billion in indirect mortality costs.
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Shingles pain occurs in ~50% of cases in older adults

Complications of shingles—including postherpetic neuralgia (PHN)—occur in almost 50 percent of older persons with the disease.
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Shingles causes >50,000 hospitalizations each year

Shingles causes around 50,000 to 60,000 hospitalizations each year in the United States.
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Increase in flu mortality between 1970 and 1990

Mortality from influenza increased from between 7,000 and 32,000 annual deaths in the 1970s, to between 36,000 and 72,000 annual deaths in the 1990s.
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Flu fatality rates in long-term care facilities

Case-fatality rates from influenza in residents of long-term care facilities range from 10% to 20%.
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Influenza-associated deaths

The annual number of influenza-associated deaths from respiratory and circulatory cases varies widely from year-to-year, ranging from an estimated 3,349 to 48,614.
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Lost productivity and healthcare visits due to flu

In one year (1995), influenza was responsible for more than:
200 million days of restricted activity
100 million days of bed disability
75 million work absenteeisms
22 million health care provider visits
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Healthcare use due to flu

In the U.S. influenza epidemics lead to around:
• 600,000 life years lost
• 3 million hospitalized days
• 30 million outpatient visits
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Hospitalization rate from flu epidemics

Every influenza epidemic, between 55,000 and 431,000 Americans are hospitalized, with a mean annual hospitalization rate of 226,000.
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Mortality rate from hospital-acquired pneumonia

The mortality rate for hospital-acquired pneumonia ranges from 38% to more than 70%.
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In 1998, community-acquired pneumonia was 6th leading cause of death

Community-acquired pneumonia is the sixth leading cause of death in the U.S. and the number-one cause of death from infection.
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